Indigestion

Also known as dyspepsia

Key points about indigestion

  • Indigestion (also called dyspepsia) is pain or discomfort in the upper part of your stomach, which feels like burning, heaviness or aching.
  • Indigestion is common. It’s uncomfortable but not serious and you can usually treat it at home with the help of your pharmacist.
Young woman on couch clutches her tummy in pain
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Indigestion (also called dyspepsia) is pain or discomfort in the upper part of your stomach, which feels like burning, heaviness or aching. It usually happens during or after eating. You might feel full sooner than you expect, bloated, less hungry, burp more, feel like you might be sick or even vomit. It can happen occasionally, for a few days of week or for some people every day.

Indigestion is common. It’s uncomfortable but not serious and you can usually treat it at home with the help of your pharmacist.

Some people with indigestion also get heartburn (gastro-eosophageal reflux disease or GORD). Heartburn is caused by acid from the stomach rising up into your food pipe (oesophagus) in your chest. It feels exactly like it’s name – burning in your chest, sometimes with an acid taste in your mouth.

Could it be a heart attack?
Some heart attacks are sudden and intense but most heart attacks start slowly, with mild chest pain or discomfort that can be easily mistaken for indigestion. Read more about signs of heart attack.

The most common type of indigestion is known as functional dyspepsia. This means the stomach is normal but it’s not working normally. This is often related to lifestyle. It can be related to irritable bowel syndrome (IBS) lower down in your gut. It may be triggered by food, drink or medication. For example:

  • eating too much or too quickly
  • fatty, greasy or spicy foods
  • too much caffeine, alcohol, chocolate or carbonated drinks
  • taking over-the-counter medications such as ibuprofen or aspirin
  • stress or anxiety.

Other causes include:

  • stomach ulcers
  • gallstones
  • coeliac disease
  • pregnancy
  • bacteria called Helicobactor pylori.

Other causes such as cancer, heart disease, disease of the digestive tract and medication effects are rare.

For about 8 out of 10 people, indigestion symptoms can settle by making some simple changes. The following tips may help prevent indigestion: 

  • Stop taking over-the-counter non steroidal anti-inflammatory medicines (NSAIDs). These are used for pain and fever and can cause indigestion. That’s aspirin, ibuprofen, naproxen and diclofenac. If that was the cause, your indigestion should start to improve after a few days and be gone within 2 weeks. Use paracetamol instead, or talk to your pharmacist about what else you can use.
  • Drink less alcohol. It’s a good idea to take a complete break for a few weeks if your indigestion is bad.
  • Cut down on coffee and fizzy drinks.
  • Quit smoking.
  • Avoid large meals, especially before you lie down if you’re getting heartburn.
  • Avoid food that makes symptoms worse (eg, fatty or spicy foods).
  • Reduce your weight if you are overweight.
  • Find ways to reduce the amount of stress you are under, or explore healthy ways of coping with it. Talk to your healthcare provider if you feel that stress is getting on top of you.
  • You can buy antacids at the supermarket which reduce the burning feeling. Read the instructions on the side and stick to them.
  • Talk to your pharmacist. There are lots of medication options you can buy over-the-counter.

Mild indigestion that happens now and again is common and nothing to worry about. However, if it doesn't come and go but stays and gets worse and worse, you should get it checked out. Also if the treatment you try doesn't work, or you have any of the things on the following list, you should see a healthcare provider to make sure there's no serious cause.

Things to look out for include:

  • unplanned weight loss 
  • trouble swallowing
  • vomiting (being sick) more than once or twice
  • black poo or blood in your poo
  • tightness or discomfort in your chest when you exercise
  • stomach cancer in your family – if your whānau come from Tairawhiti you could be at higher risk at a younger age so it's best to get checked out.

To diagnose indigestion, your healthcare provider will take a detailed history and do a physical examination to try to work out possible causes for your indigestion. It may be clear what's happening without needing any tests.

Sometimes your healthcare provider might want to send you for a blood or poo test. They might refer you to have an endoscopy (a camera down your throat to look inside your stomach).

If your healthcare provider thinks a medicine you're taking may be causing your indigestion, you might need to change medicines.

Antacids are the first treatment choice. Other medicines they may discuss with you are:

  • Proton pump inhibitors (PPIs) which can reduce stomach acid. These are useful especially if you have heartburn as well as indigestion.
  • H2-receptor blockers which can also reduce stomach acid.
  • Prokinetics which may be helpful if your stomach empties slowly.
  • Antibiotics which can help if H. pylori bacteria are causing your indigestion.
  • Antidepressants or anti-anxiety medications which may help the discomfort from indigestion by decreasing your sensation of pain.

Tell your doctor if your indigestion medication isn't helping with your symptoms, it may need to be changed or more tests arranged.

Indigestion(external link) NHS Choices, UK
Indigestion(external link) Mayo Clinic Online, US, 2013

References

  1. Managing dyspepsia and heartburn in general practice – an update(external link) Best Practice Journal, NZ, 2011
  2. Indigestion(external link) Mayo Clinic, US

Clinical guidelines

Managing dyspepsia and heartburn in general practice – an update(external link) Best Practice Journal, NZ, 2011
Management of dyspepsia and heartburn(external link) NZ Guidelines Group, 2007
Update on the evaluation and management of functional dyspepsia(external link)  American Family Physician, 2011

Continuing professional development

Long term risks of PPIs by Dr Tien Huey (external link)(The Goodfellow Unit, NZ, 2018)

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Emma Dunning, Clinical Editor and Advisor

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